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Maxillofacial neurosensory deficiencies may be caused by various surgical procedures such as tooth extraction, osteotomies, preprosthetic procedures, excision of tumors or cysts, surgery of the TMJ and surgical treatment of fractures and cleft lip/palate. These deficiencies may be intolerable for the patient, mainly because of the elective nature of the procedures such as osteotomies. In this study, a retrospective evaluation of incidence of neurosensory deficiencies (NSD) in 227 patients who underwent different kinds of surgeries in the maxillofacial region is presented. Clinical neurosensory testing such as two-point discrimination, static light touch, brush directional stroke, pin-prick, thermal discrimination and dental vitality tests were used for evaluation. All the patients were grouped according to the surgical procedures and all of them were evaluated at least one year post operation. It was concluded that osteotomies, especially sagittal split ramus osteotomies, have the highest incidence of postoperative NSD.

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Temporomandibular joint (TMJ) ankylosis is characterized by the formation of bone or fibrous adhesion of the anatomic joint components, which replaces the normal articulation and limitation of mouth opening. Early surgical intervention is considered as a treatment procedure to release the joint ankylosis and to maintain the function of the joint. Longstanding temporomandibular joint ankylosis which starts during the active growth period in early childhood resulting in facial asymmetry. Thus, the importance of the evaluation for the facial asymmetries and unfavorable remodeling of the mandible has to be considered during the initial treatment planning. Further operations, either osteotomies or distraction osteogenesis, are required for the treatment of maxillofacial deformities. The present study reports a case of unilateral TMJ ankylosis treated by interpositional arthroplasty prior to distraction osteogenesis for the treatment of mandibular secondary deformity. Various treatment procedures and timing protocols are reviewed and discussed.